Organization
VIRTUDENT MA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HITESH GULAB TOLANI DMD (CEO)
(617) 863-4569
Entity
Organization
Contact information
Practice address
21 DRYDOCK AVE. 6TH FLOOR, C/O MASSCHALLENGE, BOSTON, MA 02210
(617) 863-4569
Mailing address
21 DRYDOCK AVE, STE 610, BOSTON, MA 02210-2384
(617) 863-4569
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223D0001X
Public Health Dentistry
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
124Q00000X
Dental Hygienist
—
—
125J00000X
Dental Therapist
—
—
125K00000X
Advanced Practice Dental Therapist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
04/06/2015
Last updated
03/02/2017
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